Term
| What is the telencephalon? |
|
Definition
|
|
Term
| The lateral central fissure separates which lobes? |
|
Definition
| separates temporal lobe from frontal & pariental |
|
|
Term
| The longitudinal cerebral fissure separates what? |
|
Definition
|
|
Term
| The central sulcus separates which lobes? |
|
Definition
|
|
Term
| List the 6 paired cerebral hemispheres. |
|
Definition
| frontal, parietal, temporal, occipital, insular, & limbic |
|
|
Term
| List the three primary areas found in the frontal lobe. |
|
Definition
| primary motor cortex (precentral gyrus), prefrontal cortex, & Broca's area (controls motor aspects of speech) |
|
|
Term
| List the major areas of the parietal lobe. |
|
Definition
Primary somatosensory cortex (postcentral gyrus) - primary sensory cortex for integration of sensation from opposite side of body)
Primary vestibular cortex - recieves info regarding head mvt & position relative to gravity |
|
|
Term
| List the major areas of the temporal lobe. |
|
Definition
Primary auditory cortex - processes auditory stimuli
Associative auditory cortex - processes auditory stimuli
Wernicke's area - language comprehension |
|
|
Term
| List the major areas of the occipital lobe. |
|
Definition
primary visual cortex - recieves processes visual stimuli
associative visual cortex - processes visual stimuli |
|
|
Term
| List the location & function of the insula. |
|
Definition
deep within the lateral suclus
associated with visceral functions |
|
|
Term
| List the constituents of the limbic system & its function. |
|
Definition
limbic lobe (cingulate, parahippocampal, & subcallosal gyri), hippocampal formation, amygdaloid nucleus, hypothalamus, & anterior nucleus of thalamus
concerned with instincts & emotions, basic functions including feeding, aggression, emotions, & endorcine aspects of sexual response |
|
|
Term
| Define transverse (commissural) fibers. |
|
Definition
| white matter interconnecting the two hemispheres, including the corpus callosum, anterior commissure, & hippocampal commissure. |
|
|
Term
| Define projection fibers. |
|
Definition
| white matter that connects cerebral hemispheres with other portions of the brain & spinal cord |
|
|
Term
| Define association fibers |
|
Definition
| white matter that connects portions of information within a cerebral hemisphere, allowing cortex to function as an integrated whole |
|
|
Term
| List the components of the BG. |
|
Definition
| claustrum, caudate, putamen, globus pallidus, amygdala, substantia nigra, & subthalamic nucleus |
|
|
Term
| The BG form an associated motor system (extrapyramidal) with _____ & _____. |
|
Definition
| other nuclei in the thalamus & midbrain |
|
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Term
| Describe the oculomotor circuit of the basal ganglia (caudate loop) |
|
Definition
originates in frontal & supplementary motor eye fields:
projects to caudate:
projects to superior colliculus & frontal eye field via thalamus
functions with saccadic eye movements |
|
|
Term
| Describe the skeletomotor circuit (putamen loop) of the basal ganglia. |
|
Definition
Originates in the precentral motor & postcentral somatosensory areas:
projects to putamen: projects to GPi & SNr in external
putamen: GPe & subthalamic nuclei: GPi & SNr - indirect
scales amplitude and velocity of movements, reinforces selected pattern, prepares for movement (motor set, anticipatory movements) |
|
|
Term
| Describe the limbic circuit of the basal ganglia. |
|
Definition
originates in prefrontal & limbic areas of cortex:
projects to head of caudate nucleus:
projects to prefrontal cortex
functions to organize behaviors (executive functions, problem solving, motivation, & procedural learning) |
|
|
Term
| List the four components of the diencephalon. |
|
Definition
| Thalamus, Hypothalamus, Epithalamus, Subthalamus |
|
|
Term
|
Definition
large, egg-shaped collection of nuclei located bilaterally above brain stem
3 kinds of nuclei - sensory, motor, & other
sensory - integrate & relay sensory info from body, face, retina, cochlea, & taste receptors to cerebral cortex & subcortical region - does NOT relay olfaction (smell)
motor nuclei: relay motor information from cerebellum & globus pallidus to precentral motor cortex
other nuclei: assist in integration of visceral & somatic functions |
|
|
Term
| Describe the subthalamus. |
|
Definition
superior to substantia nigra of the midbrain.
involved in BG circuit
involved in control of several functional pathways for motor, sensory, & reticular function |
|
|
Term
| Describe the hypothalamus. |
|
Definition
integrates & controls the functions of the ANS & neuroendocrine system:
maintains body homeostasis, regulates body temp, eating, water balance, anterior pituitary function/sexual behavior, & emotion |
|
|
Term
| Describe the epithalamus. |
|
Definition
Habenular nuclei: integrates olfactory, visceral, & somatic afferent pathways
pineal gland: secretes hormones that influence pituitary gland & several other organs - influences circadian rhythm |
|
|
Term
| List the major structures of the midbrain. |
|
Definition
Basilar (anterior): cerebral peduncles, substantia nigra
Tegmentum (middle): vertical sensory tracts, superior cerebellar peduncle, red nucleus, PPN, & nuclei of cranial nerves III & IV, & periaqueductal gray.
Tectum (posterior):pretectal areas & colliculi
- superior colliculus important relay station for vision & visual reflexes
- inferior colliculus important for hearing & auditory reflexes |
|
|
Term
| The red nucleus is the origin for which tract? Where does it receive fibers from? What is the function of this tract? Where is the red nucleus located? |
|
Definition
| rubrospinal; cerebellum; important for coordination; located in tegmentum of midbrain |
|
|
Term
| Periaqueductal gray is located where? what does it do? |
|
Definition
tegmentum of midbrain.
important for suppression of pain |
|
|
Term
| List the major structures of the pons. |
|
Definition
Basilar: descending tracts (corticospinal, corticobulbar, & corticopontine), middle cerebellar peduncle, pontine nuclei, & pontocerebellar axons
Tegmentum: sensory tracts, reticular formation, autonomic pathways, MLF, & nuclei for cranial nerves V-VIII |
|
|
Term
| List the components and describe the reticular formation. |
|
Definition
complex neural network including the reticular nuclei, their connections, & asc. & desc. reticular pathways
integrates sensory & cortical info
regulates somatic motor activity, ANS function, & consciousness
modulates nociceptive/pain info
Reticular nuclei:
ventral tegmental area
PPN
locus ceruleus
raphe nuclei |
|
|
Term
| List the function of the midbrain, pontine, & medullary raphe nuclei. |
|
Definition
midbrain - effects on mood
pons - modulate neural activity & arousal
medulla - pain inhibition |
|
|
Term
| List the important structures of the medulla. |
|
Definition
Basilar: pyramids, olives
Tegmentum: inferior cerebellar peduncle & fourth ventricle, relay nuclei of dorsal columns (gracilis & cuneatus) - cross in medial lemniscus, medial longitudinal fasciulus, XII, X, & XIII |
|
|
Term
| the medial longitudinal fasciculus is important for what? |
|
Definition
| control of head movements & gaze stabilization (VOR) |
|
|
Term
| olivary nuclear complex connects the cerebellum to the brainstem & is important for... |
|
Definition
| voluntary movement control |
|
|
Term
| List the 3 functional divisions of the cerebellum. |
|
Definition
Archicerebellum (Floculonodular node)
Paleocerebellum (Rostral Cerebellum, anterior lobe, spinocerebellum)
Neocerebellum (Cerebellar Hemispheres, Posterior lobe, Pontocerebellum) |
|
|
Term
| List the functions of the Archicerebellum. |
|
Definition
| connects with vestibular sstem & is concerned with equilibrium & regulation of muscle tone - helps coordinate VOR. |
|
|
Term
| List the functions of the Paleocerebellum. |
|
Definition
| concerned with modifying muscle tone & synergistic actions of muscles - important in maintenance of posture and voluntary movement control |
|
|
Term
| List the functions of the Neocerebellum. |
|
Definition
concerned with smooth coordination of voluntary movements, ensures accurate force, direction, & extent of movement
important for motor learning, sequencing of movements, & visually triggered movements - may play a role in assisting cognitive function & mental imagery |
|
|
Term
| The spinal cord begins at the ______ & ends at _____. |
|
Definition
|
|
Term
| There are ____ spinal nerves & they are divided as: |
|
Definition
| 30 - 8 cervical, 12 thoracic, 5 lumbar, 5 sacral |
|
|
Term
| What cells are located in the anterior horn of the spinal cord? |
|
Definition
| alpha motor neurons & gamma motor neurons - efferent motor neuron cell bodies (gray matter) |
|
|
Term
| What is in the posterior horn? Where are the cell bodies? |
|
Definition
| afferent sensory neurons - cell bodies located in DRG. |
|
|
Term
| Have two enlargements in gray matter of the spinal cord. Where are they and what are they for? |
|
Definition
| cervical & lumbosacral - origins of nerves of upper & lower extremities |
|
|
Term
| Lateral horns are found in _____ & _____ segments for ______ fibers of the ANS. |
|
Definition
| thoracic & upper lumbar; preganglionic |
|
|
Term
| Describe the dorsal columns/medial lemniscus system. |
|
Definition
convey proprioception, vibration, & fine touch (tactile discrimination)
divided into fasciculus cuneatus (lateral - UE tracts) & fasciculus gracilis (medial - LE tracts)
neurons ascend to medulla where fibers cross to form the medial lemniscus
ascend to thalamus & then to somatosensory cortex
1st order neurons - DRG
2nd order neurons - nucleus cuneatus or nucleus gracilis
3rd order neurons - in VPL nucleus of thalamus |
|
|
Term
| Describe the spinothalamic tracts. |
|
Definition
Convey pain & temperature - lateral spinothalamic tract
Crude touch - medial spinothalamic tract
tracts ascend 1 or 2 spinal cord segments ipsilaterally in Lissauer's tract & then synapse & cross to the opposite side & ascend in the ventrolateral spinothalamic system to the VPL nucleus of the thalamus & to sensory cortex.
1st order neurons - in DRG
2nd order neurons - in dorsal horn (Lissauer's tract)
3rd order neurons - VPL of thalamus |
|
|
Term
| Describe the spinocerebellar tract. |
|
Definition
conveys proprioception information from the muscle spindles, GTO, & touch & pressure receptors to cerebellum for control of voluntary movements
anterior - cell bodies in lateral & ventral horns - axons cross to opp. side & ascend in the contralateral anterior spinocerebellar tract to the midbrain - leave midbrain & enter the cerebellum via superior cerebellar peduncle - fibers recross midline before entering cerebellum
posterior - transmits info from leg & lower 1/2 of body - proximal axon of first order neuron travels in dorsal columns to thoracic or upper lumbar spinal cord - synapses in dorsal gray matter (Clarke's nucleus - extends vertically from T1-L2) Second order axons form the posterior spinocerebellar tract - remains ipsilateral & projects ot cerebellar cortex via the inf. cerebellar peduncle |
|
|
Term
| Describe the spinoreticular tract. |
|
Definition
| convey deep & chronic pain to reticular formation to midline & intralaminar nuclei of the thalamus |
|
|
Term
| Describe the corticospinal tracts. |
|
Definition
arise from primary motor cortex & descend in brainstem
cross in medulla (pyramidal decussation) via lateral corticospinal tract to ventral gray matter (anterior horn cells)
10% of fibers to not cross & travel in anterior corticospinal tract to cervical & upper thoracic segments |
|
|
Term
| Describe the vestibulospinal tracts. |
|
Definition
Arise from 4 vestibular nuclei in the pontomedullary junction & descend to spinal cord in lateral (uncrossed) & medial (crossed & uncrossed = bilateral) vestibulospinal tracts
lateral - faciliate LMN to extensors & inhibit LMN's to flexors
important for control of muscle tone, antigravity muscles, & postural reflexes |
|
|
Term
| Describe the rubrospinal tract. |
|
Definition
| arises in red nucleus of midbrain, crosses to opposite side, then descends to lateral spinal cord to synapse with LMN innervating upper limb flexor muscles |
|
|
Term
| Describe the reticulospinal system. |
|
Definition
Arises in reticular formation of the brainstem & descends bilaterally in ventral & lateral columns & terminates on dorsal gray & ventral gray
modifies transmission of sensation, esp. pain & influences gamma motor neurons & spinal reflexes |
|
|
Term
| Describe the tectospinal tract. |
|
Definition
| arises from superior colliculus of midbrain & descends to ventral gray - assists in head-turning responses to visual stimuli |
|
|
Term
| the sympathetic nervous system is known as the __________ division. |
|
Definition
|
|
Term
| What is the function of the SNS? |
|
Definition
| prepares body for fight or flight, emergency responses, increases heart rate & BP, constricts peripheral blood vessels, & redistributes blood; inhibits peristalsis |
|
|
Term
| the parasympathetic nervous system is known as the _________ division. |
|
Definition
| craniosacral division (C.N. III, VII, IX, X, & pelvic nerves) - conserves & restores homeostasis, slows heart rate, decreases BP, increases peristalsis & glandular activity |
|
|
Term
| Describe the descending autonomic system |
|
Definition
| arises from control centers in the hypothalamus & lower brainstem & projects to preganglionic ANS segments in thoracolumbar (sympathetic) & craniosacral (parasympathetic segments) |
|
|
Term
| Which C.N. of the autonomic system provide visceral afferent sensations? Efferent outflow? |
|
Definition
afferent - IX, X
efferent - III, VII, IX, X |
|
|
Term
| What two layers of meninges make up the subarachnoid space? What is in this area? |
|
Definition
| between arachnoid mater & pia mater - CSF, cisterns, & major arteries here |
|
|
Term
| Describe the horns of the lateral ventricles of the brain. |
|
Definition
| have anterior (frontal), posterior (occipital), & inferior (temporal) horns |
|
|
Term
| The lateral ventricles communicate with the third ventricle through... |
|
Definition
|
|
Term
| The _______ joins the third & fourth ventricle. |
|
Definition
|
|
Term
| Where is the fourth ventricle located? |
|
Definition
|
|
Term
| What are the two characteristics of the fourth ventricle? |
|
Definition
| foramina (openings of Luschka) & Magendie communicate fourth ventricle with subarachnoid space |
|
|
Term
|
Definition
| choroid plexuses in the ventricles |
|
|
Term
| What is normal pressure for CSF in the ventricles? |
|
Definition
|
|
Term
| Describe the blood-brain barrier. |
|
Definition
| selective restriction of blood-borne substances from entering the CNS - associated with capillary endothelial cells |
|
|
Term
| Describe the vascular supply to the brain. |
|
Definition
Carotid system - internal carotids come off of common carotids & form anterior & middle cerebral arteries
Vertebrobasilar systems - vertebral arteries arise from subclavian arteries & unite to form the basilar artery - bifurcates into two posterior cerebral arteries
Circle of Willis - formed by anterior communicating artery connecting two anterior cerebral arteries & the posterior communicating artery connecting each posterior & middle cerebral artery |
|
|
Term
| Describe the venous drainage system of the brain. |
|
Definition
| cerebral veins & dural venous sinuses. |
|
|
Term
| What areas of the brain do the Carotid & Vertebrobasilar systems supply? |
|
Definition
carotid: large area of brain & many deep structures
vertebrobasilar: supplies brainstem, cerebellum, occipital lobe, & parts of thalamus |
|
|
Term
| Nuclei are groups of what? What are they called in the PNS? |
|
Definition
| nerve cell bodies; ganglia |
|
|
Term
| Describe the neuronal resting membrane potential. |
|
Definition
positive on outside, negative on inside (-70mV)
AP: increased permeability of Na influx into cell with outflow of K - results in polarity changes to +35 mV & depolarization
generation of AP is all or none |
|
|
Term
|
Definition
large, myelinated, fast conducting
Alpha: Proprioception, somatic motor
Beta: touch, pressure
Gamma: motor to muscle spindles
Delta: pain, temperature, touch |
|
|
Term
|
Definition
| small, myelinated, conduct less rapidly, pregangllionic autonomic |
|
|
Term
|
Definition
smallest, unmyelinated, slowest conducting
-dorsal root: pain, reflex responses
-sympathetic: postganglionic sympathetics |
|
|
Term
| Cranial nerve I - name, motor/sensory/mixed, function, & test. |
|
Definition
Olfactory
Sensory only
Sense of smell
Test sense of smell on each side & close off opp. nostril |
|
|
Term
| Cranial nerve II - name, motor/sensory/mixed, function, & test. |
|
Definition
Optic
Sensory only
Tests pupillary light reactions - pupil should constrict with light shined into eye |
|
|
Term
| Cranial nerve III - name, motor/sensory/mixed, function, & test. |
|
Definition
Oculomotor
Parasympathetic & Motor
Tests pupillary reflexes & turns eye up, down, & in |
|
|
Term
| Cranial nerve IV - name, motor/sensory/mixed, function, & test. |
|
Definition
Trochlear
Motor only
turns adducted eye down
tests pursuit eye movement |
|
|
Term
| Cranial nerve V - name, motor/sensory/mixed, function, & test. |
|
Definition
Trigeminal
Mixed
Sensory to face & cornea
Motor to temporal & masseter muscles |
|
|
Term
| Cranial nerve VI - name, motor/sensory/mixed, function, & test. |
|
Definition
Abducens
Motor only
abducts eye
test pursuit eye movements |
|
|
Term
| Cranial nerve VII - name, motor/sensory/mixed, function, & test. |
|
Definition
Facial nerve
Mixed
Sensation from head
Motor to muscles of facial expression
Ask patient to make faces |
|
|
Term
| Cranial nerve VIII - name, motor/sensory/mixed, function, & test. |
|
Definition
Vestibulocochlear
Sensory only
Vestibular function, VOR, cochlear function
Test hearing, gaze instability with head rotations, & balance |
|
|
Term
| Describe sensorineural loss vs. conductive hearing loss. |
|
Definition
sensorineural loss - sound is heard longer through air than bone
conductive loss - sound heard through bone is equal or longer than air |
|
|
Term
| Cranial nerve IX - name, motor/sensory/mixed, function, & test. |
|
Definition
Glossopharyngeal
Mixed
Speaking, swallowing reflex, palate & pharynx control, & gag reflex |
|
|
Term
| Cranial nerve X - name, motor/sensory/mixed, function, & test. |
|
Definition
Vagus
Mixed
Phonation, swallowing, pharynx control, gag reflex |
|
|
Term
| Cranial nerve XI - name, motor/sensory/mixed, function, & test. |
|
Definition
Spinal accessory
Motor
innervates traps & SCM |
|
|
Term
| Cranial nerve XII - name, motor/sensory/mixed, function, & test. |
|
Definition
Hypoglossal
Motor
Tongue movements
Have patient stick tongue out or notice resting tongue position |
|
|
Term
| T/F. There is no dorsal root ganglion for C1. |
|
Definition
|
|
Term
| List the cord levels for the cervical, brachial, and lumbar plexus. |
|
Definition
cervical C1-4
brachial C5-T1
lumbar T12-L4
sacral plexus L4-S3 |
|
|
Term
| Describe monosynaptic stretch reflex |
|
Definition
| 1a afferents from muscle spindle to a.m.n. projecting back to muscle - DTR |
|
|
Term
| Describe reciprocal inhibition. |
|
Definition
| Same as monosynaptic stretch reflex, but inhibitory interneuron inhibits antagonist muscle. |
|
|
Term
| Describe the inverse stretch (myotatic reflex) |
|
Definition
stimulus is muscle contraction
Afferent 1b fiber from GTO via an inhibitory interneuron to muscle of origin - provides agonist inhibition, diminution of force of agonist contraction, stretch protection reflex |
|
|
Term
| Describe the gamma reflex loop. |
|
Definition
allows muscle tension to come under control of descending pathways (reticulospinal, vestibulospinal, & others)
descending pathways excite gamma motor neurons, causing contraction of muscle spindle & increased stretch sensitivity & increased rate of firing from spindle afferents - impulses are then conveyed to a.m.n. |
|
|
Term
| Describe the flexor withdrawal reflex |
|
Definition
stimulus is cutaneous sensory stimuli
cutaneous receptors via interneurons to flexor muscles - functions as a protective withdrawal mechanism to remove body part from harmful stimuli |
|
|
Term
| Describe the crossed extension reflex. |
|
Definition
stimulus: noxious stimuli & reciprocal action of antagonists; flexors of one side are excited causing extensors on same side ot be inhibited, opposite responses occur in opposite limb
coordinates reciprocal limb activities such as gait |
|
|
Term
|
Definition
| patient can open eyes and look at examiner, but demonstrates decreased alertness, confusion, and decreased interest in environment |
|
|
Term
| Glasgow Coma Scale (GCS) relates consciousness to which 3 elements of response? |
|
Definition
| eye opening, motor response, & verbal response |
|
|
Term
| The scoring range for the GCS is ___-____. What do the scores mean? |
|
Definition
3-15
severe brain injury = <8
moderate = 9-12
minor = 13-15 |
|
|
Term
| MMSE includes what screening items & what is scoring? |
|
Definition
orientation, registration, recall, language, calculation, & attention
max score is 30
21-24 indicates mild cognitive impairment
16-20 moderate impairment
<15 indicates severe impairment |
|
|
Term
| Define Cheyne-Stokes respiration |
|
Definition
| a period of apnea lasting 10-60 seconds followed by slow increased in depth & frequency of respirations; usually accompanies depression of frontal lobe & diencephalon dysfunction. |
|
|
Term
| Damage to what area causes hyperventilation? |
|
Definition
|
|
Term
| Define apneustic breating. Damage to what area causes it? |
|
Definition
abnormal respiration marked by prolonged inspiration
damage to upper pons |
|
|
Term
|
Definition
| flex patient's hip & knee to 90 deg. & then extend patient's knee - when U/L suggest HS tightness, with pain & increased resistance B/L, suggests meningeal irritation. |
|
|
Term
| Define Brudzinski's sign. |
|
Definition
| with pt. in supine, flex head to chest - will see hip & knee flexion B/L. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| ability to identify similar size/shaped objects placed in hand with different weights |
|
|
Term
|
Definition
| ability to recognize numbers, letters, or symbols traced on the body, esp. hand |
|
|
Term
| Define homonymous hemianopsia. |
|
Definition
| loss of half of a visual field in each eye contralateral to the side of a cerebral hemisphere lesion. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Severe denial, neglect, or lack of awareness of severity of condition |
|
|
Term
|
Definition
| inability to recognize familiar objets with one sensory modality, but can with others. |
|
|
Term
| Define the two types of apraxia. |
|
Definition
Ideomotor apraxia - cannot perform the task on command, but can do when left to own
Ideational apraxia - patient can't perform task at all. |
|
|
Term
| Describe grading for Modified Ashworth Scale. |
|
Definition
0 - no spasticity present
1 - slight increase in muscle tone, minimal resistance at end ROM
1+ - slight increase in muscle tone, minimal resistance through less than half of ROm
2 - more marked increase in muscle tone, through most of ROM - affected part easily moved
3 - considerable increase in muscle tone, passive mvt difficult
4 - affected part rigid in flexion or extension |
|
|
Term
| Describe leadpipe & cogwheel rigidity. |
|
Definition
leadpipe - increased resistance to PROM, independent of velocity of mvt, that is uniform throughout the range
cogwheel rigidity - rigidity interrupted by a series of jerks throughout the movement |
|
|
Term
| Describe decerebate rigidity posturing & where lesions are usually located. |
|
Definition
everything in extension
brainstem lesions between superior colliculus & vestibular nucleus |
|
|
Term
| Describe decorticate posturing & where lesions are located. |
|
Definition
lesions above superior colliculus
upper limbs in flexion, lower limbs in extension |
|
|
Term
|
Definition
prolonged severe spasm of muscles causing head, back, & heels to arch backwards - arms & hands are held rigidly flexed
seen in severe meningitis, tetanus, epilepsy, & strychnine poisoning |
|
|
Term
| Describe scoring for reflexes. |
|
Definition
0 - absent
1+ - tone change, no visible movement of extremities
2+ - visible movement of extremities
3+ - exaggerated movement of extremities
4+ - obligatory & sustained movement, lasting > 30 seconds |
|
|
Term
| Describe the Modified Fatigue Impact Scale (MFIS). |
|
Definition
| scores fatigue on 3 subsets - physical, cognitive, & psychosocial function |
|
|
Term
| Describe the motions of the following joints for flexor synergy: scapula, shoulder, elbow, forearm, wrist & finger. |
|
Definition
scapula: retraction
shoulder: ABD & ER
elbow: flexion
forearm: supination
wrist: flexion
finger: flexion |
|
|
Term
| Describe the movements of the following joints in extensor synergy: scapula, shoulder, elbow, forearm, wrist, fingers. |
|
Definition
scapula: protraction
shoulder: adduction & IR
elbow: extension
forearm: pronation
wrist: flexion
finger: flexion |
|
|
Term
| Describe the movements at the following joints for flexor synergy: hips, knee, ankle. |
|
Definition
hip: flexion, ABD, & ER
knee: flexion
ankle: dorsiflexion & inversion |
|
|
Term
| Describe the motions at the following joints for extensor synergy: hip, knee, ankle. |
|
Definition
hip: extension, IR, ADD
knee: extension
ankle: PF & inversion |
|
|
Term
|
Definition
Certified test for sensory interaction in balance. Has 6 conditions.
Modified CTSIB - EOSS, ECSS, EOFS, ECFS - ability to maintain each of the four conditions. |
|
|
Term
| Describe the 6 conditions for a CTSIB. |
|
Definition
Condition 1: EO, stable surface
Condition 2: EC stable surface
Condition 3: EO, sway reference on stable surface
Condition 4: EO, moving surface
Condition 5: EC, moving surface
Condition 6: EO, sway reference, moving surface |
|
|
Term
| Patients dependent on vision become unstable in what conditions for the CTSIB? |
|
Definition
|
|
Term
| Patients dependent on somatosensation become unstable in what conditions of the CTSIB? |
|
Definition
|
|
Term
| Patients dependent on vestibular inputs become unstable in which conditions of the CTSIB? |
|
Definition
|
|
Term
| Describe scoring for the Tinetti. |
|
Definition
Max score is 28
<19 = high fall risk
19-24 = moderate |
|
|
Term
| Describe scoring for the BERG balance scale. |
|
Definition
| Max score 56 - patients who score <45 = high fall risk - with scores 54-46, 1 pt. drop is associated with 6-8% increase in fall risk |
|
|
Term
| Describe scoring for TUG. |
|
Definition
normal 11-20 normal for frail elderly or disabled patients
>20 increased fall risk
>30 high fall risk |
|
|
Term
| Describe scoring for Functional & multidirectional reach. |
|
Definition
above avg. >12.2
below avg. <5.6
<10 = increased fall risk
Multi:
Backwards:above avg = >7.6, below = <1.6
Lat: above avg.= >9.4, below avg = <3.8 inches |
|
|
Term
| irreversible anoxic damage to brain begins after _______. |
|
Definition
|
|
Term
|
Definition
| ACA supplies anterior 2/3 of medial cerebral cortex: produces contralateral sensory loss & hemiparesis, leg more involved than arm |
|
|
Term
|
Definition
lateral cerebral cortex, basal ganglia, & internal capsule supplied by MCA.
contralateral sensory loss & hemiparesis, arm more involved than leg, produces motor speech dysfunction, perceptual dysfunction (parietal sensory association cortex affected), homonymous hemianopsia (optic radiation of IC), & loss fo conjugate gaze to opp. side |
|
|
Term
| Describe Medial medullary syndrome. |
|
Definition
| ipsilateral paralysis of tongue, contralateral paralysis of arm & leg with impaired sensation |
|
|
Term
| Describe lateral medullary (Wallenberg's) syndrome. |
|
Definition
| ipsilateral cerebellar symptoms - ataxia, vertigo, nausea, & vomiting, Horner's syndrome (miosis, ptosis, decreased sweating), dysphagia, impaired speech, diminished gag reflex, sensory loss of ipsilateral arm, trunk, or leg, contralateral pain & temp |
|
|
Term
| Describe basilar artery syndrome. |
|
Definition
| brainstem signs & symptoms & PCA signs & symptoms - "locked in syndrome" - basilar artery occlusion at level of pons (quadriplegia & bulbar paralysis) - unable to move or speak but has full cognitive function, often fatal with sensation often intact |
|
|
Term
| Describe medial inferior pontine syndrome. |
|
Definition
| ipsilateral signs & symptoms - cerebellar nystagmus, ataxia, paralysis of conjugate gaze, diplopia, & contralateral signs - hemiparesis, impaired sensation |
|
|
Term
| Describe lateral inferior pontine syndrome. |
|
Definition
| ipsilateral signs & symptoms - cerebellar nystagmus, vertigo, nausea, vomiting, ataxia, facial paralysis, paralysis of conjugate gaze to the side of the lesion, deafness, tinnitus, impaired facial sensation, & contralateral impairment of pain & temperature of half of the body |
|
|
Term
|
Definition
| contralateral homonymous hemianopsia, contralateral sensory loss, involuntary movements, contralateral hemiparesis, Weber's syndrome (oculomotor nerve palsy with contralateral hemiplegia) |
|
|
Term
| List the 6 sequential recovery stages of stroke. |
|
Definition
1: initial flaccidity, no voluntary movement.
2: emergence of spasticity, hyperreflexia, synergies
3: voluntary movement in synergies - strong spasticity
4: voluntary control in isolated joint movements
5: increasing voluntary control out of synergy, coordination deficits present
6: control & coordination near normal |
|
|
Term
|
Definition
| functional assessment measure: in addition to the 18 FIM items, includes additional functional areas, including community access, instrumental ADL's, safety, employability, & adjustment |
|
|
Term
| Describe patients with left hemisphere CVA vs. R. |
|
Definition
L - slow, cautious, hesitant, & insecure - speech deficits usually on this side
R - perceptual deficits, impulsive, quick, indifferent, exhibit poor judgement & safety, overestimate abilities |
|
|
Term
| List the function & cause of a lesion to BA 4 in the frontal lobe. |
|
Definition
discrete volitional movements
contralateral paresis & paralysis |
|
|
Term
| List the function and cause of a lesion in BA 8 in the frontal lobe. |
|
Definition
conjugate eye movements
paralysis of conjugate eye movements to opp. side |
|
|
Term
| List the function and cause of a lesion to areas 44 & 45 of the frontal lobe. |
|
Definition
language production
nonfluent aphasia. |
|
|
Term
| List the function and damage a lesion would cause to the dorsolateral prefrontal cortex. |
|
Definition
motivation, problem solving, judgement
impaired ability to concentrate, easily distracted, loss of initiative, apathy, cannot make decisions |
|
|
Term
| List the function and what a lesion in the orbitofrontal cortex of the frontal lobe would do. |
|
Definition
emotions, behavior
emotional lability, unpredictable and frequent unacceptable behavior |
|
|
Term
| List the function and what a lesion to the orbital gyri in the posterolateral prefrontal cortex would do. |
|
Definition
olfaction
unable to discriminate odors. |
|
|
Term
| List what the function and a lesion to BA 3, 1, & 2 would cause. |
|
Definition
somatosensation
loss of contralateral sensation |
|
|
Term
| List what the function and a lesion to area 43 in the parietal lobe would cause. |
|
Definition
taste
impairment of taste in contralateral side of tongue |
|
|
Term
| List what the function and a lesion to the superior & inferior parietal lobules would cause. |
|
Definition
processes somatic & visual info
tactile and visual agnosia, visual disorientation, neglect of contralateral self & surroundings |
|
|
Term
| List what the function and lesion to BA 41 would cause. |
|
Definition
hearing
decrease in hearing & ability to localize sounds, contralaterally |
|
|
Term
| List the function & what a lesion to BA 22 would do. |
|
Definition
Wernicke's
language comprehension
fluent aphasia impairment of learning & memory |
|
|
Term
| List what the temporal cortex function is and what a lesion in this area would produce. |
|
Definition
storage of visually presented info
impairment of learning & memory |
|
|
Term
| List what the parahippocampal function is and what a lesion would produce. |
|
Definition
recent memory
profound memory loss of recent events & no new learning |
|
|
Term
| List what a lesion to BA 17 would cause & function. |
|
Definition
vision
contralateral homonymous hemianopsia |
|
|
Term
| List what the function and a lesion to BA 18 & 19 would do. |
|
Definition
visual association
color agnosia & loss of spatial relationships (can't draw to scale maps) |
|
|
Term
| Describe the level of spinal cord injury. |
|
Definition
most distal uninvolved nerve root segment with at least 3/5 - all above are 5/5
Sensory - grade 0-2 - lowest level with 2 = sensory level - estimate motor from sensory when motor not available. |
|
|
Term
| Describe ASIA A, B, C, D, & E. |
|
Definition
ASIA A - complete SCI.
ASIA B - incomplete SCI, sacral sensation is preserved in S4-5, but not motor
ASIA C - incomplete - motor function preserved in S4-5 with sacral sparing and most muscles below injury have grade of <3
ASIA D - incomplete motor function is preserved below level and most have a level of 3 or more
E - motor & sensory function is normal |
|
|
Term
| Describe anterior cord syndrome. |
|
Definition
| loss of motor & pain & temperature, with sparing of proprioception/fine touch |
|
|
Term
| Define Brown-Sequard syndrome. |
|
Definition
| ipsilateral motor & proprioception/light touch loss, with contralateral pain & temp. loss |
|
|
Term
| Define central cord syndrome. |
|
Definition
| loss of more centrally located weakness (arm) with preservation of more peripherally located lumbar & sacral tracts - also lose pain & temp |
|
|
Term
| Describe multiple sclerosis. |
|
Definition
chronic progressive demyelinating disease of the CNS
likely viral, autoimmune
demyelinating lesions impair neural transmission & cause nerves to fatigue rapidly - common in pyramidal tract, dorsal columns, & periventricular areas of cerebrum & cerebellar peduncles |
|
|
Term
| Describe relapsing-remitting MS. |
|
Definition
| characterized by relapses with either full recovery or some remaining neuro signs/symptoms & residual deficit on recovery - periods between defined by lack of disease progression. |
|
|
Term
| Describe primary progressive MS. |
|
Definition
| disease progression from onset, without plateaus or remissions or with occasional plateaus and minor improvements |
|
|
Term
| Describe secondary progressive MS. |
|
Definition
| initial relapsing-remitting, then progression at a variable rate that may include relapses & minor remissions. |
|
|
Term
| Describe progressive relapsing MS. |
|
Definition
| progressive disease from onset but without clear acute relapses that may or may not have some recovery or remission |
|
|
Term
| Describe medical management of MS. |
|
Definition
Immunosuppressant drugs - treat acute flare ups
ACTH, steroids (prednisone, dexamethaxone, betamethasone, methylprednisolone)
Interferon drugs: slow progression of the disease & decrease symptoms
Avonex, Betaseron, Copaxone
Management of urinary problems
Anticholinergic drugs
Managment of Spasticity
Baclofen, Diazepam, Dantrolene, phenol block surgery |
|
|
Term
| List the 5 PD stages on the Hoehn & Yahr classification. |
|
Definition
I. Minimal or absent disability, U/L symptoms
II. Minimal B or midline involvement, no balance involvement
III. Impaired balance, some restriction in activity
IV. All symptoms present & severe, stands & walks only with assistance
V. Confinement to bed or w/c |
|
|
Term
| Describe medical management of PD. |
|
Definition
SInemet (levidopa/carbidopa) - provides dopamine
numerous side effects including N/V, OH, cardiac arrhythmias, involuntary movements, psychoses & abnormal behaviors
Dopamine agonist drugs:enhance Sinemet:Bromocriptine, Pergolide, Mesylate
Anticholinergic drugs: for tremor
Amantadine increases dopamine release
Selegilide (Deprenyl) Monoamine Axidase inhibitor increases dopamine - used during early disease to slow progression
Surgery: thalamotomy, pallidotomy, DBS (deep brain stimulation in thalamus or subthalamic nuclei) |
|
|
Term
| Define myasthenia gravis. |
|
Definition
neuromuscular junction disorder characterized by progressive muscular weakness & fatiguability on exertion.
autoimmune antibody-mediated attack on ACh receptors at NMJ |
|
|
Term
| List the 4 types of myasthenia gravis. |
|
Definition
Ocular masthenia
Mild generalized myasthenia
Severe generalized myasthenia
Crisis
General - usually involves bulbar (extraocular, facial, & muscles of mastication) & proximal limb girdle musculature
Crisis - myasthenia gravis with respiratory failure; treat as medical emergency |
|
|
Term
| List medical interventions for myasthenia gravis. |
|
Definition
Acetylcholinesterase inhibitors - pyridostigmine
Corticosteroids
Immunosuppresants - asathioprine, IVIG
Alternative treatments - plasmapheresis, thymectomy |
|
|
Term
| Describe Tonic-clonic seizures. |
|
Definition
| dramatic loss of consciousness with a cry, fall, & tonic-clonic convulsions of all extremities - usually lasts 2-5 minutes, consciousness is gradually regained |
|
|
Term
| Describe absence seizures. |
|
Definition
| brief, almost imperceptible lapse of consciousness followed by immediate & full return to consciousness, posture maintained, no convulsive muscle contractions - can have hundreds per day. |
|
|
Term
| Describe simple partial seizures. |
|
Definition
focal, begin locally, limited to a portion of the body, usually have an identifiable structural cause
can be focal motor: involves specific part of body
can be focal motor with march (Jacksonian): starts in one part of the body & spreads to involve adjacement muscles of entire body side
can be temporal lobe seizure - characterized by episodic changes in behavior, complex hallucinations, automatisms (lip smacking, chewing, pulling on clothing), altered cognition & emotional function (sexual arousal & depression, violent behaviors - preceeded by an aura |
|
|
Term
| Describe complex partial seizures |
|
Definition
| simple partial seizures followed by an impairment of consciousness |
|
|
Term
| Describe status epilepticus. |
|
Definition
| prolonged seizure or series of seizures with very little recovery between attacks lasting >30 min. - may be life threatening; considered a medical emergency. |
|
|
Term
| List medical intervention for seizures. |
|
Definition
phenytoin (Dilantin), carbamazepine (Tegretol, phenobarbitol
surgical intervention: lobe resection, hemispherectomy. |
|
|
Term
| Describe what lesions of the archicerebellum would cause. |
|
Definition
central vestibular systems - ocular dysmetria, poor eye pursuit, dysfunctional vestibular ocular reflex (VOR), impaired hand-eye coordination
Gait & eye ataxia: poor postural control & orientation, wide-based gait
Little change in tone or dyssynergia of extremity movements |
|
|
Term
| Describe what lesions of the paleocerebellum would cause. |
|
Definition
hypotonia, truncal ataxia, dysequilibruim, statis postural tremor, increased sway, wide BOS & high guard arm position, posture worse with eyes closed, narrow BOS
ataxic gait, unsteady, increased falls, uneven decreased step length, increased step width |
|
|
Term
| Describe what lesions of the paleocerebellum would cause. |
|
Definition
hypotonia, truncal ataxia, dysequilibruim, statis postural tremor, increased sway, wide BOS & high guard arm position, posture worse with eyes closed, narrow BOS
ataxic gait, unsteady, increased falls, uneven decreased step length, increased step width
errors in timing related to perceptual tasks |
|
|
Term
| Describe what a lesion to the neocerebellum would cause. |
|
Definition
Ataxic limb movements
Dysdiadochokinesia
Dysmetria
Dyssynergia
Errors in timing related to perceptual tasks |
|
|
Term
|
Definition
|
|
Term
| Describe Wallerian degeneration. |
|
Definition
transection (neurotmesis) results in degeneration fo the axon and myelin sheath distal to the site of axonal interruption. - chromatolysis & repair processes occur in nerve cell body
endoneurium does not degenerate but fors a tube directing regeneration |
|
|
Term
| Describe segmental demyelination. |
|
Definition
| axons are preserved (no wallerian degeneration): remyelination restores function (ex. GBS) |
|
|
Term
| Describe axonal degeneration. |
|
Definition
| degeneration of an axon cylinder & myelin, progressing from distal to proximal - "dying back" of nerves |
|
|
Term
| Define peripheral neuropathy. |
|
Definition
| any disease of nerves characterized by deteriorating neural function. |
|
|
Term
|
Definition
| involvement of nerve roots. |
|
|
Term
| List the three types of traumatic nerve injuries. |
|
Definition
| Neurapraxia, Axonetmesis, Neurotmesis |
|
|
Term
|
Definition
| injury to nerve that causes transient loss of function - nerve dysfunction may be rapidly reversed or persist a few weeks. |
|
|
Term
|
Definition
| injury to nerve interrupting the axons & causing loss of function and wallerian degeneration distal to the lesion - with no disruption of endoneurium, regeneration is possible (ex. crush injury) |
|
|
Term
|
Definition
| cutting of the nerve with severance of all structures and complete loss of function - reinnervation typically fails without surgical intervention because of aberrant regeneration (failure of regenerating axon to find its terminal end. |
|
|
Term
| Describe the cause of trigeminal neuralgia. |
|
Definition
| results from degeneration or compression (tortous basilar artery or cerebellopontine tumor) of C.N. V |
|
|
Term
| List the characteristics of trigeminal neuralgia. |
|
Definition
occurs along the distribution of C.N. V, mandibular & maxillary divisions (opthalmic usually not involved) - restricted to 1 side of face
exacerbated by stress, cold, light touch to face, lips, or gums, extremes of heat or cold, chewing, talking, brushing teeth, movement of air across face |
|
|
Term
| List medical interventions for trigeminal neuralgia. |
|
Definition
anticonvulsants, vitamin B12, alcohol injections, surgery (sectioning of the nerve, permanent anesthesia)
TENS for pain relief |
|
|
Term
| List the cause of Bell's palsy. |
|
Definition
| actue inflammatory process of unknown etiology, resulting in compression of C.N. VII within temporal bone |
|
|
Term
| List the characteristics of Bell's palsy. |
|
Definition
muscles of facial expression on one side are weakened or paralyzed
loss of control of lacrimation & salivation
onset is acute, with max severity in a few hours or days, with a day or two of pain behind the ear - most recover fully in several weeks or months
normal sensation |
|
|
Term
| Which cranial nerves participate in taste? Which areas? |
|
Definition
VII ant. 2/3 of tongue
IX post. 1/3 of tongue |
|
|
Term
| List medical management of Bell's palsy. |
|
Definition
| corticosteroids (prednisone), & analgesics |
|
|
Term
| List the cause of bulbar palsy. |
|
Definition
refers to weakness or paralysis fo the muscles innervated by the motor nuclei of the lower brainstem, affecting the muscles of the face, tongue, larynx, & pharynx.
- the result of tumors, vascular or degenerative disease of lower cranial nerve motor nuclei (ex. ALS) |
|
|
Term
| List the characteristics of bulbar palsy. |
|
Definition
glosspharyngeal & vagal paralysis - phonation, articulation, palatal action, gag reflex, impaired swallowing
changes in voice quality: dysphonia (hoarseness or nasal quality
B/L involvement: airway restriction, aspiration pneumonia |
|
|
Term
| Differentiate between bulbar palsy & pseudobulbar palsy. |
|
Definition
pseudobulbar palsy - B/L dysfunction of corticobulbar innervatino of brainstem nuclei; a central or UMN lesion analogous to corticospinal lesions disrupting function of anterior horn cells
pseudobulbar palsy will have hyperactive reflexes - increased jaw jerk & snout reflex - tapping on lips produces pouting of lips |
|
|
Term
| Define & list the cause of GBS. |
|
Definition
acute, ascending symmetrical polyneuropathy
associated with an autoimmune disease - usually occurs after recover from an infectious illness |
|
|
Term
| List the characteristics of GBS. |
|
Definition
invovles acute demyelination of both cranial & peripheral nerves
have sensory loss, paresthesias, pain (sensory loss typically less than motor
motor paresis or paralysis - symmetrical - progresses from lower extremities to upper, distal to proximal
dysarthria, diplopia, & dysphagia may develop in severe cases
evolves over a few days to weeks - recovery is slow - 6 mo. to 2 years & usually complete
3% mortality |
|
|
Term
| List medical management for GBS. |
|
Definition
Plasmapheresis
IVIG
Analgesics for pain relief |
|
|
Term
| List the characteristics of ALS. |
|
Definition
Bulbar onset - progressive bulbar palsy
Spinal cord onset - progressive muscular atrophy
early onset involves limbs & spreads to whole body - atrophy, cramping, muscle fasciculations, or twitching (LMN signs)
spasticity, hyperreflexia (UMN signs)
dysarthria, dysphagia, dysphonia secondary to pseudobulbar palsy & progressive bulbar palsy
usually no sensory changes - 20% may show sensory deficits
autonomic dysfunction in 1/3 of patients
pain d/t spasticity, cramping, postural stress syndrome, joint hypomobility, or instability
typically spare B&B function
cognition is normal, similar to locked-in syndrome |
|
|
Term
| List & Describe the 6 stages of ALS. |
|
Definition
Stage I: early disease, mild focal weakness, asymmetrical distribution; symptoms of hand cramping & fasciculations
Stage II: moderate weakness in groups of muscles, some wasting of muscles, MI with AD
Stage III: severe weakness of specific muscles, increasing fatigue, mild to moderate functional limitations, ambulatory
Stage IV: severe weakness and wasting of LE's, mild weakness of UE's, mod. A & AD required, w/c user
Stage V: w/c dependent for mobility - progressive weakness with deterioration of mobility & endurance, increased fatigue, moderate to severe weakness of whole limbs & trunk, spasticity, hyperreflexia, loss of head control, max A
Stage VI: bed bound, progressive respiratory distress |
|
|
Term
|
Definition
| ALS Functional Rating Scale: assesses disease progression & function across 10 functional categories - scored 0-4 - 40 max score |
|
|
Term
| List medical management for ALS. |
|
Definition
| Riluzole, a glutamate agonist, may slow progression, prolong survival, esp. with bulbar onset disease |
|
|
Term
| Define & list etiology for PPS. |
|
Definition
postpolio syndrome or progressive postpolio muscular atrophy (PPPMA) - a new, slowly progressing muscle weakness occurring in individuals with a confirmed history of acute poliomyelitis - follows a stable period of functioning
unknown - could be hyperfunctioning of motor neurons, long-term overuse at high levels resulting in new denervation |
|
|
Term
| List characteristics of PPS |
|
Definition
new weakness & atrophy, asymmetrical in distribution.
Occurs in both initially weak & uninvolved muscles
abnormal fatigue (doesn't recover easily with usual rest periods
pain, myalgia, cramping pain, joint pain
decreased function with reduced endurance for routine activities
slow progression
environmental cold intolerance
difficulty in concentration, memory, attention, damage to reticular formation, hypothalamus, dopaminergic neurons
sleep disturbances
decreased functional mobility, aerobic capacity, labile exercise blood pressures
slow progression, can be steady or stepwise |
|
|
Term
| List medical management of PPS. |
|
Definition
Antidepressants (amitriptyline (Elavil), fluoxetine (Prozac))
Neurotransmitter inhibitors (decreases fatigue & sleep disorders (serotonin, norepinephrine) |
|
|
Term
| Fast pain is transmitted over ____ fibers, which are polymodal & non-myelinated. |
|
Definition
|
|
Term
| Describe the fast pain pathway. |
|
Definition
A delta fibers to spinal cord doral horn (Lissauer's tract) - crosses to opp. side & travels up lateral spinothalamic tract; terminates in brainstem reticular formation & thalamus & then to somatosensory cortex
functions for localization, discrimination of pain. |
|
|
Term
| Describe the slow pain pathway. |
|
Definition
| C fibers to dorsal horn of spinal cord (Lissauer's tract), to cross to anterior spinothalamic tract - terminates in brainstem reticular formation, excites RAS, functions for diffuse arousal, affective, and motivational aspects of pain, and also terminates in thalamus with projections to somatosensory cortex. |
|
|
Term
| Describe the gate control theory. |
|
Definition
| transmission of sensation at spinal cord level is controlled by balance between large (A alpha, A beta) & small (A delta, C fibers) - activity of large fibers at level of first synapse can block activity of small fibers & pain transmission (counterirritant theory) |
|
|
Term
| Describe the descending analgesic system. |
|
Definition
| endogenous opiates - endorphins & enkephalins produced throughout the CNS (ex. periaqueductal gray, raphe nuclei, pituitary gland/hypothalamus, SC laminae I & II) can depress pain transmission at various sites through mechanisms of presynaptic inhibition. |
|
|
Term
| How long does pain have to persist to be considered chronic? |
|
Definition
|
|
Term
| Describe neuropathic pain. |
|
Definition
| pain as a result of lesions in some part fo teh nervous system (central or peripheral) - usually accompanied by some degree of sensory deficit |
|
|
Term
|
Definition
| intense, continuous, central pain occuring on contralateral hemiplegic side - result of a stroke involving the ventral posterolateral thalamus - autonomic & vasomotor dysfunction common |
|
|
Term
|
Definition
a complex disorder that develops as a consequence of trauma affecting body parts & disuse
- regional because it affects an entire limb (arm or leg) & not in a peripheral nerve or nerve root distribution
typically worse more distally
pain is severe - out of context to original injury
early symptoms include vasodilation of the skin, abnormal sweating, edema, & skin atrophy
Late changes include atrophy of the skin, muscles, & joints; osteoporosis - may develop muscle paresis & spasms |
|
|
Term
| Describe reflex sympathetic dystrophy. |
|
Definition
aka causalgia, shoulder hand syndrome, & Sudeck's atrophy
diffuse, persistent pain involving central reorganization of sensory systems - typically develops as a result of trauma to a peripheral pathway with sympathetic overactivity
categorized as a syndrome under CRPS. |
|
|
Term
| Define the three states of RSD. |
|
Definition
Acute stage: diffuse, severe burning or aching pain, increases with emotional stress, allodynia (pain on light touch) & hyperpathia (increased sensitivity to normal stimuli); vasomotor instability with dusky mottling, cool skin, swelling, & edema
Dystrophic stage: skin changes: thin, pale, cyanotic skin; cessation of hair & nail growth; hyperhidrosis; muscle atrophy & osteoporosis
Atrophic or late stage: decreased hypersensitivity, normal blood flow & temperature - smooth, glossy skin: severe muscles atrophy, pericapsular fibrosis; diffuse osteoporosis - development of claw hand may occur |
|
|
Term
|
Definition
an acute, painful mononeuropathy caused by the varicella zoster virus - characterized by vesicular eruption & marked inflammation of the posterior root ganglion of the affected spinal nerve or sensory ganglion of cranial nerve
ventral root involvement (motor weakness) in 5-10% of cases - infection can last from 10 days to 5 weeks & postherpetic neuralgia can last for years |
|
|
Term
|
Definition
| widespread pain accompanied by tenderness of muscles & adjacent soft tissues, a nonarticular rheumatic disease of unknown origin |
|
|
Term
| Describe myofascial pain syndrome. |
|
Definition
| MPS - persistent, deep aching pains in uscle - nonarticular in origin - characterized by well-defined, highly sensitive tender spots (trigger points) |
|
|
Term
| Describe the purpose of approximation in PNF. |
|
Definition
| stimulates afferent nerve endings and prepares extensor muscles for stabilizing patterns |
|
|
Term
| Describe the purpose of traction in PNF. |
|
Definition
| a distraction force to stimulate afferent nerve endings and facilitate flexor muscles |
|
|
Term
| Describe the purpose of quick stretch in PNF. |
|
Definition
| muscle elongation (stretch reflex) stimulates muscle contraction |
|
|
Term
| List the indications for rhythmic initiation. |
|
Definition
| inability to initiate movement, uncoordinated motion, general tension or tonal impairments, motor learning deficits, communication deficits |
|
|
Term
| List the indications for rhythmic rotation. |
|
Definition
| general tension or hypertonia with limitations in function or ROM |
|
|
Term
| List indications for Stabilizing Reversals (alternating isometrics) |
|
Definition
| indicated for decreased stability, poor antigravity control, & weakness |
|
|
Term
| List indications for slow reversals |
|
Definition
| decreased active ROM, weakness of antagonistic muscles, decreased reciprocal control, hypertonic muscle groups |
|
|
Term
| List indications for agonist reversals. |
|
Definition
| weak postural musculature, inability to eccentrically control body weight during movement transitions (ex. sitting down), decreased active ROM, control, & weakness |
|
|
Term
| List indications for hold-relax-active motion |
|
Definition
| inability to initiate movement, hypotonia, weakness |
|
|
Term
| List indications for contract relax. |
|
Definition
| limitations in ROM cause by muscle tightness, spasticity |
|
|
Term
| List indications for hold-relax. |
|
Definition
| limitations in ROM caused by muscle tightness, muscle spasm & pain |
|
|
Term
| List indications for repeated contractions. |
|
Definition
| weakness, fatigue, decreased ability to perform the desired pattern |
|
|
Term
| List the D1 flexion & extension patterns of the UE. |
|
Definition
D1F: flexion, adduction, external rotation
D1E: extension, abduction, internal rotation |
|
|
Term
| List the D2 flexion & extension patterns of the UE. |
|
Definition
flexion: flexion, ABD, ER
extension: extension, ADD, IR |
|
|
Term
| List the D1 flexion & extension pattern of the LE. |
|
Definition
flex, ADD, ER
ext, ABD, IR |
|
|
Term
| List the D2 flexion & extension patterns for the LE. |
|
Definition
flexion, ABD, IR
extension, ADD, ER |
|
|
Term
| With chopping, the lead arm moves into what pattern? |
|
Definition
|
|
Term
| With lifting, the lead arm goes into what UE pattern? |
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Definition
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Term
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Definition
| practice of a single motor skill repeatedly; repetitive practice |
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Term
| Define variable practice. |
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Definition
| practice of varied motor skills in which the performer is required to make rapid modifications of the skill in order to match the demands of the task. |
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Term
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Definition
| practice of a group or class of motor skills in random order |
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Term
| Describe serial practice. |
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Definition
| practice of a group or class of motor skills in serial or predictable order |
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Term
| Describe massed practice. |
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Definition
| relatively continuous practice in which the amount of rest time is small |
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Term
| Describe distributed practice. |
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Definition
| practice in which the rest time is relatively large |
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Term
| Describe mental practice. |
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Definition
| cognitive rehearsal of a motor skill without over physical performance. |
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Term
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Definition
| a functional task is selected and is progressively made more difficult - goal is for participant to accomplish the task with effort |
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Term
| List the training patterns for CIMT & mCIMT. |
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Definition
CIMT - intense - several hours/day, every day, for 2-3 consecutive weeks
mCIMT - 1 hr/day, 3 days/wk, for 8 weeks |
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Term
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Definition
| working on task-specific training can lead to patients who cannot easily generalize these tasks to other environmental situations or other similar tasks - seen in patients with brain injury. |
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Term
| Which tongue muscle is not innervated by C.N. XII? Which C.N. is it innervated by? |
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Definition
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Term
| Define Horner's syndrome. What causes Horner's syndrome? |
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Definition
| ptosis of eyelid, pupil constriction, & loss of sweating of ipsilateral face involves stroke of posterior or anterior inferior cerebellar artery |
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Term
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Definition
| Inability to judge distances |
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Term
| What causes Morton's neuroma? |
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Definition
excessive pronation during stance - causes compression between the 3rd & 4th metatarsals
- nerve can enlarge, causing a neuroma on the 3rd & 4th met heads, causing metatarsalgia |
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Term
| List the three visual field deficits that can result from stroke and where the lesions are located. |
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Definition
optic nerve damage - blindness in one eye (monocular blindness)
optic chiasm damage - bitemporal hemianopsia - damage to the outer portions of each eye - "tunnel vision"
optic tract damage - homonymous hemianopsia - damage to both the right or left halves of both eyes - occurs contralaterally |
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Term
| What does damage to the anterior inferior cerebellar artery cause? |
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Definition
| U/L hearing loss, ataxia, vertigo, dizziness, contralateral pain & temperature loss, paresis of lateral gaze, & Horner's syndrome (loss of sweating to half of face, pupil constriction, & ptosis) |
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Term
| What does damage to the posterior inferior cerebellar artery do? |
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Definition
Wallenberg's syndrome - vertigo, nausea, hoarseness, dysphagia, ptosis, ipsilateral loss of facial sensation & contralateral paresis of arm & limb
could also have Horner's syndrome (ptosis, loss of sweating on half of face, & constricted pupil) |
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Term
| What does damage to the superior cerebellar artery do? |
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Definition
| ataxia, dysarthria, dysmetria, & contralateral loss of pain & temperature |
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Term
| How can you assist with posterior lifting of the tongue for assistance with swallowing? |
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Definition
| firm pressure on the anterior 1/3 of tongue |
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Term
| How can sucking be encouraged? |
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Definition
| deep pressure to the neck above the thyroid notch |
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Term
| List the names of the VIII levels of Rancho Los Amigos Levels of Cognitive Functioning. |
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Definition
I - no response
II - Generalized Response
III - Localized Response
IV - Agitated, Confused
V - Inappropriate & Confused
VI - Confused & Appropriate
VII - Automatic & Appropriate
VIII - Purposeful & Appropriate |
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Term
| Neuropathic, thalamic pain is due to damage of the _____ of the thalamus and is due to a stroke of the _______ artery. |
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Definition
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Term
| A patient with PD usually develops what contractures of the UE? |
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Definition
| elbow flexion, shoulder adduction, & flexed, stooped posture |
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Term
| Differentiate between fluent & non-fluent aphasia. |
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Definition
Broca's - non-fluent aphasia
Wernicke's - fluent aphasia (ease of producing speech is not affected) |
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